Inspection on 24/10/08 for 8 Brantwood Road

This inspection was carried out on 24th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

8 Brantwood Road 18/10/06

8 Brantwood Road 29/11/05

8 Brantwood Road 13/04/05

8 Brantwood Road 20/01/05

8 Brantwood Road 02/08/04

8 Brantwood Road 17/02/04

8 Brantwood Road 08/07/03

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 8 Brantwood Road 8 Brantwood Road Luton LU1 1JJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrea James     Date: 2 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 8 Brantwood Road 8 Brantwood Road Luton LU1 1JJ 01582480642 Telephone number: Fax number: Email address: Provider web address: noemailasat03.07.07 Name of registered provider(s): Name of registered manager (if applicable) Mrs Bertha Kamuna Type of registration: Number of places registered: Advance Support Ltd care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Advance Housing and Support Ltd is a charitable organisation providing services within the community to meet the needs of people who have either a learning disability or a mental health problem. 8 Brantwood Road is a semi-detached house and is located near the town centre of Luton and overlooks the park. The home provides accommodation for five people with mental health needs. All the people using the service have single rooms. The first floor has four bedrooms, a bathroom and utility room. The downstairs has one bedroom, a lounge and kitchen/diner, a toilet, separate smoking room and an office. There is also a small garden at the rear of the house. At the front of the building is a small driveway. The accommodation is not suitable for people with mobility problems. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is a 2 star. This means that people who use the service experience a good quality outcome. This was an unannounced inspection carried out on the 21st of October 2008. The registered manager was present for the duration of the site visit, which lasted for 5.5 hours. The report consists of information received from people using the service, care staff, and the manager. Other evidence used included information received from questionnaires and the AQAA (Annual Quality Assurance Assessment). Care Homes for Adults (18-65 years) Page 5 of 28 The report followed a case tracking methodology were a sample of people were selected at random to see what it was like for them living at the home. These peoples care plans were inspected and where possible, they and their key workers were spoken to. What the care home does well: What has improved since the last inspection? What they could do better: The service should ensure that all risk assessments undertaken clearly shows the level of risk posed to the person being assessed. Tighter procedures should also be in place to ensure people working in the home have satisfactory documentation that shows their authenticity in regards to recruitment. The people using the service could benefit from having their own transport to ensure they are able to access the community as a group if they so desired. Care Homes for Adults (18-65 years) Page 7 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had made appropriate arrangements to ensure people receive sufficient information about the service and that their needs are satisfactorily assessed. Evidence: Three of the five peoples documentations were inspected at this site visit. In all cases information was available to suggest people were given sufficient information to be able to make a choice about using the service. People spoken to said they were given a service user guide and as a result knew what services were provided before their placement became permanent. A Statement of Purpose was also made available and was updated to reflect current resources provided by the home. This document was updated in May 2008. Peoples documents seen also suggested comprehensive needs assessments were undertaken prior to and during their placement at the home. The needs assessments were also updated on a regular basis to reflect the current needs of people. This document was detailed and covered areas such as religion, social, family, personal Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: care, diet, sight, hearing, communication and mental health. People spoken to said they were included in the assessment process. One person said, he recently had a review and was able to say how he felt he had developed. Individual contracts were also seen for people using the service. This contract detailed the cost of the placement, and there was evidence to suggest people who used the service, or their representatives signed and dated the document. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were satisfactorily recorded with clear interventions but further development was needed to ensure the risk assessments have clear risk levels identified. Evidence: The care plans inspected, suggested peoples needs were accurately reflected and interventions implemented were clear and consistent throughout. The care plans were current and reflected peoples activities, health, nutrition, mental health issues, lifestyle choices and other areas of individual needs. There was evidence that people received annual reviews and the changes were reflected in the care plans. One person spoken to said they received a review two weeks ago and on inspection the care plan was already written and implemented to reflect the current needs. People spoken to said they were involved in the care planning process and as a result, knew what to do on a day-to-day basis. One person said. We have to do our chores Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: and I cook on a Tuesday, Wednesday and Thursday. another person said I go to a day centre. There was sufficient evidence to suggest the home reviewed on a regular basis the mental health state of the people using the service. Various documentations seen such as relapse indicators documents, risk assessments, medical emergency plans, risk control measures and monthly one-to-one sessions suggested peoples mental state were closely monitored. There was evidence to suggest all people who needed to be risk assessed had recieved this assessment and they were kept under review, but further development was needed to ensure the level of risk is clearly identified. The risk assessments inspected failed to show if the risk to people were high, medium or low. Risk assessments seen included assessments for people to self medicate, keep their own monies and access community resources. People were able to make decisions about their own lives with assistance and support from the staff team. One person said he had just embarked on a relationship and staff were supportive to him. Another person spoken to said they were able to make decisions about their day-to-day living to include what to eat, and were to go on a daily basis. The service encouraged all users to participate as much as they can in the daily living skills of the home. People spoken to said they were able to perform daily chores around the house to include cleaning their rooms, laundering of your clothing and preparing meals. One person was even able to undertake the food shopping unaided. Various risk assessments were seen to suggest people were encouraged to take calculated risks in order to maximise their independence and develop an independent lifestyle. Care staff spoken to, said one person was risk assessed in order for him to be able to self medicate. One person spoken to, said he was encouraged to do as much as he could for himself. He had access to his own computer and telephone. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities were made available for people using the service in regards to personal development, activities and dietary needs, as a result people are able to lead a normal life. Evidence: Recorded evidence suggested people were given opportunities for personal development. Care staff spoken to said people are given opportunity for development but felt that the home could benefit from having their own transport as one person living in the home was not able to take public transport and had to rely heavily on taxis. People spoken to confirmed that they felt that they would benefit from a minibus. People spoken to said they were encouraged to participate in appropriate activities. Some people using the service were currently attending college courses, day centres and various community resources. One person who chose to stay home was Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: able to do flower arranging on a weekly basis to ensure continuous stimulation was maintained, another person had achieved a BTEC level 3 qualification. People spoken to said they were able to take part in age and cultural appropriate activities. The home showed that they were able to meet people with cultural needs and this was reflective on the day of the site visit where a person from a Muslim culture was encouraged to attend the appropriate activities that meets her needs within the community. The menu and storage of food within the home also reflected cultural diversity. There was evidence to suggest people were enabled to maintain family and other relationships were appropriate. People spoken to said they were encouraged to have visitors to the home whenever they wished. One person spoke proudly of the relationship he had with his newly found girlfriend and said staff were supportive in helping him to maintain this relationship. The dietary needs of the people using the service was of a satisfactory standard. People spoken to were able to say what they had for their meals. They were conscious of the requirements for healthy eating. The menus were drawn up collectively by the people using the service with the support of the staff team and the stocks seen reflected the menu plan. Staff spoken to said all the people using the service got involved in food preparation, and they would sit together and eat on a regular basis. One person said, I like it here the food is nice. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had made appropriate arrangements for the personal and health care needs of people as a result individuals living in the home received personal support in the way they wished. Evidence: People using the service received personal support in the way they preferred and required. There was evidence obtained from the documentations inspected to suggest peoples emotional health care needs were being met. Risk assessments undertaken and reviewed demonstrated the proactive way in which the home identified peoples mental health. The mental health assessments suggested relapse indicators were closely monitored and staff were aware when peoples mental health had deteriorated. One document seen stated that if one person started to talk about aliens and spaceships this was a clear indicator that his mental state had deteriorated. The monitoring of peoples health care was also evident in the regular monitoring of peoples weights. The home stated in their AQAA (Annual Quality Assurance Assessment)that they were working on new policies to be implemented to reflect the Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: needs and wishes of people in the event they become ill or in the event of their death. This information was recorded on the care planning documentations inspected. One person using the service had lived in the some since 1989 and the home had ensured that her needs were met. The home was also reviewing the impact the Mental Capacity Act will have on people when making decisions. Care staff spoken to said they were being trained in understanding the Mental Capacity Act and how it relates to the people they care for. The home had satisfactory policies and procedures in place for the safe storage and administration of medication. This policy was reviewed in May 2007 but a risk assessment was recently undertaken for medication on the 29/07/08. The medication information was kept for all people using the service with their photograph, name, list of the medication and the receipt and disposal of all medication. Medication stocks seen and the medication administration record sheets (MARS) were satisfactorily maintained. The home was also in the process of assessing one person to be able to self medicate. This person spoken to was able to confirm that he was being assessed to be able to self medicate and was given medication to take with him when he visited his girlfriend on the weekend. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were safeguarded and procedures were in place to ensure their views were listened to. Evidence: There were no complaints recorded in the complaints register since the last inspection. The documentations seen for the three people case tracked showed that a copy of the complaints procedure was in place. This document was also available in the communal areas of the home. People spoken to said they knew how to complain and felt confident and able to do so. One person said I would speak to the manager. The home have not received or made any safeguarding alerts since the last inspection. Care staff spoken to said they knew what to do if they suspected people were being abused. The financial procedures in place for keeping peoples monies were satisfactory. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a comfortable and safe environment that ensured peoples privacy and dignity were maintained. Evidence: The standards of the home were of a satisfactory level. On the day of the site visit we were able to tour the environment and found the home to be clean and free from offensive odours. During the day people were seen to be undertaking their daily chores, which included hoovering and cleaning of bedrooms and communal areas. There were some areas of the home that failed to have control valves fitted to hot water taps but immediate actions were taken on the same day to ensure people were not at risk of scalds or burns. Some people invited us into their rooms which appeared suitably decorated and met with individual needs. One person had his own computer, DVD player and telephone in his bedroom. All bedrooms seen suggested peoples comforts were assured, as they suited their needs and lifestyle choices. One person said i am happy with my room, it suits me OK. The environmental health assessment carried out in May 2008 suggested the home Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: posed a low risk to people. There were clear guidelines and procedures for maintaining cleanliness of the home. Since the last inspection a new bathroom and shower room was installed for people using the service. The home had undertaken various health and safety measures to protect people to include regular PAT tests. There was evidence that Infection control measures were in place and people were aware of how to store different foods. Various fridge freezer temperatures and temperatures for recording cooked meats were implemented. The home had sufficient bathroom and toilet facilities to meet the needs of the five people currently using the service. The communal space provided for eating and lounging appeared satisfactory in meeting with the peoples needs and all areas throughout were clean and free from offensive odours. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were protected by a trained, competent and qualified staff team but further development was needed to ensure robust recruitment procedures are followed at all times, as a result people could be placed at risk. Evidence: The home made improvement to the staffing levels since the last inspection. The home now has three full-time support workers, a deputy manager and a registered manager. This ensures satisfactory support is available for people on a 24-hour basis. The day of the inspection, one member of staff was rostered on with the manager work in close by in a supernumerary position. Care staff spoken to said they felt this level of staffing was sufficient to meeting the needs of people who use the service. Staff files inspected suggested satisfactory recruitment policies and procedures were in place for some care staff but for one care staff who had been transferred from a previous home over a year ago the documentation was still not in place. The file inspected failed to have an application form or references. The care staff spoken to was able to confirm that she had worked in the home for over 1 year. Another carers file was not available for inspection as she too had been transferred from another home and her documentation had not yet been transferred to rhis service. Since the Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: inspection we have been told that these documents are now in place. There was evidence to suggest other files contained satisfactory Criminal Record Bureau checks, application forms, references and health checks. There was evidence to suggest new employees received satisfactory inductions using Skills For Care induction packages. Staff spoken to said they were issued with personnel Manuals and code of Conduct booklets. People spoken to said, staff are helpful, they guide us through the day. Our observations throughout the day suggested care staff and the people using the service had a friendly but professional relationship and the communication between them were of a comfortable manner. Staff spoken to said they received satisfactory levels of training, and this was evidenced through various certificates and records inspected. All staff had obtained an NVQ level 3 in care and staff development plans were in place for all staff working at the home. A training schedule, dated 2008/2009 suggested care staff were enabled to embark on various courses on a regular basis. There was a need for some care staff to have updates for mandatory training but this was identified for future training by the manager. There was also evidence to suggest specialist training was arranged for staff. This included introduction to Islam and Muslim culture, medication, mental capacity Act and fire and safety. Staff spoken to said they felt supported by the management team and receive regular supervision and staff meetings. There was recorded evidence to suggest supervisions and monthly meetings were undertaken on a regular basis. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management ethos of the home was suited to the needs of people, as a result people benefited from a well run home. Evidence: The home was run and managed by a registered manager along with a full time deputy manager. The manager recently obtained her NVQ level 4 in management and her Registered Managers Award. She was due to embark on further management qualifications in the near future. People spoken to all said the manager was OK. One person said the manager is fine. The care staff spoken to also said they felt supported by the manager and said she was always available when needed. The policies and procedures in place on the day of the site visit suggested robust management input was being undertaken. The home had developed their quality assurance system and questionnaires were seen that had recently been collected from people using the service and the staff team. The Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: manager said she was in the process of analysing these data. The home also had other ways of monitoring the views of people using the service. One person said, I have a one to one talk with my key worker monthly. This was evidenced by records seen in peoples files. Care staff said people had residents meetings and they were very vocal and would say when they were not happy with something. The home had a health and safety policy and several procedures were in place to suggest peoples safety were maintained. Records inspected suggested weekly, monthly tests were undertaken to ensure fire safety. Records were kept for hot and cold water temperatures, carbon monoxide tests and other records of interest to protect people using the service. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Arrangements must be made to ensure risk assessments undertaken highlights the level of risk posed to the person being assessed. To ensure unneccessary risks to peoples health and safety are clearly identified and recorded. 30/12/2008 2 34 19 Arrangements must be 30/11/2008 made to ensure documentations in accordance with schedule 2 are maintained and available for all staff working in the home. To ensure people using the service are protected by the recruitment procedures being used. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Adults (18-65 years) Page 26 of 28 No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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